New GOP Congress Develops Alternate Health Plans

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House lawmakers are planning to vote for a 60th time today to repeal the president’s health care law – a vote that’s legislatively pointless but politically symbolic. Many of the 47 GOP freshmen who were elected last November won at least in part because their constituents were anti-Obamacare.

This is the first time the new GOP-controlled Congress is voting against the law, which now requires Republicans to develop real alternatives.

Most GOP lawmakers admit that full repeal won’t happen during Obama’s final term – so they’ve set their sights on more realistic ways to scrap the health law before edging in their replacement.

Right now, their best shot is a Supreme Court ruling that could do the unraveling for them. If the High Court rules against the administration in King v. Burwell and strikes down federal subsidies for some 4.8 million people who bought health coverage in the federal marketplace, GOP lawmakers have said they would not restore the subsidies – essentially letting the law collapse.

The Court will hear the case in March and render its decision in June. In the meantime, the GOP is crafting response strategies and alternatives.

Last Friday, three top House committee leaders – House Ways and Means Chairman Paul Ryan (R-WI), Energy and Commerce Chairman Fred Upton (R-MI), and Education and Workforce Chairman John Kline (R-MN) – announced they’ll lead a task force to develop an ACA alternative ahead of the Court’s ruling. Senate Republicans have also started a similar working group with the same objective.

Rep. Tom Price (R-GA), the new chair of the House Budget Committee, has floated the notion of providing affordable coverage through tax credits and deductions, luring people in through positive incentives – as well as letting people take their health coverage with them from job to job. Republicans have also attempted a piecemeal approach: They’ve taken aim at less popular provisions of Obamacare one by one, including the law’s medical device tax and its 30-hour workweek.

Earlier this month, the House voted to expand Obamacare’s 30-hour workweek provision to a 40-hour threshold as part of the employer mandate. Currently, employers with more than 50 full time workers (with “full time” defined as workers logging 30 hours a week) must provide health coverage to these workers.

The House bill would instead define full time workers as those who put in 40 hours a week. Critics of the 30-hour threshold say it prompts workers to cut hours as well as jobs; the Senate still hasn’t taken up the bill but Obama has already threatened a veto.

Republican leaders, meanwhile, have said repealing the law’s 2.3 percent tax on medical devices is a top priority in 2015. The repeal has bipartisan support, including from Democrats in states like Minnesota, where big medical device companies are based. The White House previously threatened to veto it but hasn’t weighed in this year.

The health care law has signed up more than 10 million people so far, but it has not done anything to rein in costs. A recent survey from the Commonwealth Fund found that roughly 66 million Americans have delayed getting medical care for cost reasons over the last 12 months.